ALBERTA AMATEUR WRESTLING
11759 GROAT RD. EDMONTON, AB T5M 3K6 PHONE (780) 415-0140 FAX (780)422-2663
www.albertaamateurwrestling.ca
[email protected]
2017 Canada Summer Games Boy’s Talent Identification Camp
The coaching staff of the boy’s team at the 2017 Canada Summer Games would like to invite all
male wrestlers (born in 1998, 1999, 2000) who are interested in representing Alberta in 2017 to
attend this talent identification camp! Come meet the coaching staff, learn valuable technique
and work with your fellow Team Alberta hopefuls!
Who: All athletes born in 1998, 1999, 2000
Cost: $100 (includes lunch), all participants must be AAWA members (if not, an additional $10
charge will apply)
*Billeting Available* Contact Adam Link <[email protected]>
Date: February 20-21, 2016
Location: Alexander Forbes School
7240 Poplar Drive
Grande Prairie, AB
February 20
February 21
Session 1: 12:00 pm – 2:00 pm
Session 1: 9:00 am – 12:00 pm
Lunch: 2:00 pm – 3:00 pm
Session 2: 3:00 pm – 5:00 pm
Please return the completed attached registration form, waiver and medical form to
[email protected]
Payment can be made by calling the AAWA office 780-415-0140 or 780-643-0799 before the
event or handed in at the event. Cheques can be made out to Alberta Amateur Wrestling
Association.
Camp Director, Mike Dunn, can be reached at [email protected]
2017 CSG Men’s Talent ID Camp
REGISTRATION FORM
Feb. 20-21, 2016 GRANDE PRAIRIE, AB
Camp Director
Mike Dunn
Name: ______________________________________________________________
Birthdate: _____________________________
Mailing Address: ______________________________________________________________
STREET
______________________________________________________________________________
CITY
PROV.
POSTAL CODE
Phone: _________________________ Email: _________________________
Club/School: _______________________________________Years Experience: ________
Emergency Contact: ________________________________________________________
NAME
Athlete [ ]
PHONE #
Coach [ ]
2017 CSG Men’s Talent ID Camp
Feb. 20-21, 2016
Waiver and Assumption of Risk Agreement
I, ______________________, hereby acknowledge that participation in the athletic events and
planned activities of the Men’s Talent ID camp might result in personal injury, property damage
and/or loss. I fully understand these risks and hereby agree to participate in the Men’s Talent ID
camp voluntarily and at my own risk.
I agree that the Alberta Amateur Wrestling Association, and any of their servants, agents,
sponsors, volunteers or employees will not be held responsible for any accidents or loss however
caused and agree to release that same from all claims or damages that may arise as a result of or
by any reason of such accidents or loss.
___________________________________
Signature of Participant
_____________________________
Participant Name (Please Print)
_____________________________
_______________________
Parental Signature (if participant under 18)
Date
Note:. This waiver must be handed in prior to participation in the camp.
2017 CSG Men’s Talent ID Camp
Medical Information
NAME:_______________________________________________________________________
ADDRESS:____________________________________________________________________
Apt#
Street
_______________________________________________(___)__________________________
Prov.
Postal Code
Home Phone
BIRTHDATE:________________________ _____ AGE:__________ GENDER:_______
Month
Day
Year
PROVINCIAL HEALTH CARE
#:____________________________________________________
PRIVATE HEALTHCARE
#:________________________________________________________
FAMILY DOCTOR:_______________________ PHONE:_____________________________
ALLERGIES:
_____________________________________________________________________
______________________________________________________________________________
MEDICATION
__________________________________________________________________
______________________________________________________________________________
Do you presently or have you had any of the following:
_____Heart Problems
_____Serious neck or back problems
_____Problems due to hot or cold weather
_____Epilepsy
_____Head injury / concussion (within the last year)
_____Asthma (wheezing or bronchitis)
_____Diabetes
_____Kidney problems
_____Infectious diseases (e.g. mono, ringworm) within the last year
_____Traumatic or overuse injury to any joint, bone, ligament or tendon (within the last year)
_____Major surgical procedure within the last year